Testicular Self Exam (TSE)

What is TSE and why should men do it?

TSE is a simple and effective way for men to recognize the early signs and symptoms of testicular cancer. Testicular cancer is one of the most frequently occurring types of cancer in men ages 18 to 35 and can occur anytime after the age of 15. And if it is caught early, testicular cancer is one of the most curable forms of cancer.

What are the risk factors for testicular cancer?

There is evidence that the risk of testicular cancer is higher in men whose testicles did not descend normally. That means that during childhood development the testicles did not move down from the lower abdomen into the scrotum. For this reason, surgery is often performed to correct this problem before the testicle has been left undescended for very long.

According to the National Cancer Institute, a man's race/ethnic background can be another risk factor. The incidence rate (out of 100,000) for testicular cancer is 6.5 for White men; 3.4 for Latino men; 2.6 for American Indian/Alaskan Native men; 2.1 for Asian/Pacific Islander men and 1.2 for African American men. The reason for different incidence rates is unknown and continues to be researched. 

Other risk factors for testicular cancer include:

  • Family history
  • Occupational risks
  • Cancer of the other testicle
  • Injury to the testicles
  • HIV infection

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When should I perform TSE and how often?

TSE should be performed once a month after a warm bath or shower. The heat causes the scrotal skin to relax, making it easier to find anything unusual. The procedure itself is simple and should only take a few minutes. It may help you to remember to do TSE if you choose a date each month that's easy to remember like your birth date or the first of each month. Performing TSE on a regular basis will allow you to become familiar with the size and feeling of your testicles and can help you detect any changes if they occur.

How do I perform TSE and what am I looking for?

TSE is simple to perform and can quickly become a part of your routine. You can also ask your partner if they would perform TSE for you.

  • Examine each testicle separately.
  • Using both hands, put your thumbs on top of the testicle and the pads of your fingers under and behind the testicle.
  • Gently slide or roll the skin of the scrotum across the testicle. Do not rub.
  • Examine the entire area of the testicle. The surface should feel smooth, without lumps or tenderness.
  • Feel the side of the testicle closest to the body for the epididymis. The epididymis is a comma-shaped, cord-like tube that stores and transports sperm. Don't mistake the "lump" of the epididymis for an abnormal lump. Cancerous lumps are more commonly found at the front of the testicle. If you're not sure if you have felt the epididymis or a lump, make an appointment at Health Services. You can request a medical provider by name or gender.

It is normal for a man's testicles to be different sizes, and for one to hang lower and a bit behind the other. The scrotum regulates the heat of the testicles by relaxing and lowering the testicles away from the body when they are warm, and contracting and pulling the testicles up close to the body when they are cold. This temperature regulation is necessary for sperm production.

When performing TSE you are looking for:

  • Small, hard, non-tender lump or nodule in the testicle
  • Enlarged testicle and/or a feeling of extra heaviness in the testicle
  • Change in the way the testicle feels or in its consistency
  • Dull ache in the lower abdomen or groin.

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What does it mean if I find a lump?

Lumps are not always cancer. However, if you notice a lump, enlargement, tenderness or other unexplained changes in your testicles, talk to your medical provider right away. Brown students can make an appointment at Health Services (401.863-3953) and you can request a provider by gender or by name. The change may be a sign of infection in the testicle (epididymitis) or of testicular torsion (a condition in which the testicle becomes rotated inside the scrotum and becomes "strangulated," which cuts off the blood supply. If left uncorrected, this can result in the loss of a testicle).

If you are diagnosed with testicular cancer, the good news is that it is more than 95% curable when detected and treated early. However, testicular cancer may spread rapidly if detection and treatment is delayed.

Testicular cancer almost always occurs in only one testicle. Only 2% of men diagnosed with testicular cancer will develop a new tumor in the other testicle. Because the testes do not readily take in anticancer drugs, treatment of testicular cancer typically necessitates surgical removal of the affected testicle. While this thought makes most men apprehensive, be assured that one healthy testicle is sufficient for full sexual and reproductive function.

Should I make an appointment to get a testicular exam?

It's recommended that healthy men under age 40 have a testicular exam by a medical provider every 1 to 2 years. Brown students can make an appointment at Health Services (401.863-3953) and you can request a provider by gender or by name. For more information on men's health exams, click here.

Links you can use

To learn more about TSE and testicular cancer, you can visit:

The Testicular Cancer Resource Center

Medline Plus Health Center for Testicular Cancer

www.carpetestes.org 

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Disclaimer: BWell Health Promiotion is part of Health Services at Brown University. Health Promotion maintains this site as a resource for Brown students. This site is not intended to replace consultation with your medical providers. No site can replace real conversation. Health Promotion offers no endorsement of and assumes no liability for the currency, accuracy, or availability of the information on the sites we link to or the care provided by the resources listed. Health Services staff are available to treat and give medical advice to Brown University students only. If you are not a Brown student, but are in need of medical assistance please call your own health care provider or in case of an emergency, dial 911. Please contact us if you have comments, questions or suggestions.